New research confirms what some studies have suggested—that steroid injections timed within a month of rotator cuff surgery could increase risk of infection for patients.
The shoulder joint offers a greater range of flexibility than any other joint in the body. From injury, overuse, or age, shoulder pain is a frequent symptom for many people. Estimates suggest approximately 600,000 undergo shoulder surgery of some type each year. Resting over the shoulder joint, your rotator cuff is a group of muscles that allow arm movement and support overhead use of your arm. The rotator cuff also holds your shoulder joint in place.
Treatments for Shoulder Pain
Conservative treatment of shoulder pain is usually recommended before considering surgical options. Injection of corticosteroids to the shoulder is commonly suggested to reduce inflammation and pain associated with minor shoulder injury. Steroid injections are not a long-term fix, though, as they have side impacts that can worsen the condition of the shoulder joint over time. Some of those effects can be nerve and joint damage, thinning of tissue, inflammation, infection, and bone death. The use of steroids is a balancing act. While steroids are considered useful to treat tissue tears, they also appear to weaken tendons and musculature.
When shoulder pain does not subside, surgical intervention may become an option. Surgical procedures include open, arthroscopic surgery, or techniques including tendon transfer or shoulder replacement.
Steroid Injection and Rotator Cuff Surgery
Steroid injections have been linked with increased risk of additional rotator cuff surgery and with infection after a rotator cuff surgery.
In research presented to the American Orthopaedic Society for Sports Medicine in 2018, study authors analyzing a databank of approximately 5,000 surgical records found that patients who received steroid injections within the six months prior to rotator cuff surgery were more likely to need additional surgery within three years, compared with patients who had not received steroid injections.
A study published in April in the Journal of Bone and Joint Surgery looked at the rate of surgical site infection for patients who had rotator cuff surgery. The study examined data from 60,000 patients who had undergone arthroscopic surgery between the years 2007 and 2016.
Researchers found that the risk of surgical site infection was markedly greater for patients who had received a steroid injection during the month prior to their rotator cuff surgery. Corticosteroid injections received at other times during the year prior to their surgery did not appear to boost risk of a surgical infection, compared with patients who did not receive injections.
When thinking about shoulder surgery, talk to an experienced physician about your options—and best practices in scheduling your surgery if steroid injections are part of your treatment plan.
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